Margaret Miracle, MA, CCC-SLP, AVT

Individual provider Active NPI Speech-Language Pathologist · Baxter, KY

NPI 1356550263 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1356550263
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
3087 (KY)
Practice address
1148 Coldiron Heights
Baxter, KY 40831
Phone
(606) 573-6052
Fax
(606) 573-4030
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3087KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
East Kentucky Speech Hearing and Therapy Services Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3087 KY Yes

Addresses

Primary practice location

1148 Coldiron Heights
Baxter, KY 40831

Mailing address

PO Box 1001
Harlan, KY 40831-1001
Phone (606) 574-1430

Other providers in Baxter, KY

All providers in Baxter, KY · Speech-Language Pathologist in Kentucky

Sources for this page

Verify at the official NPI Registry.